CMS Formulary

Displaying 168291-168300 of 1611142 results.
ID: 168291
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168292
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168293
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168294
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168295
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168296
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168297
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168298
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168299
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168300
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0